Veterans care still 'high risk' as Trump mulls VA head

FILE - In this June 21, 2013, file photo, the seal a fixed to the front of the Department of Veterans Affairs building in Washington. Veterans health care remains a "high risk" issue threatening the federal budget and quality of care for former service members, auditors say in a forthcoming report. (AP Photo/Charles Dharapak, File)

WASHINGTON (AP) — Veterans health care remains a "high risk" issue threatening the federal budget and quality of care for former service members, auditors say in a forthcoming report.

The nonpartisan Government Accountability Office will place the Veteran Affairs Department's health system once again on its "high risk" list when it's released next month. Issued every two years, the list identifies troubled federal programs that could cause significant problems due to waste, fraud, mismanagement or structural flaws.

The draft report finds that the VA has made only limited progress since a scandal erupted over lengthy wait-times for veterans, Sen. Jon Tester, the top Democrat on the Senate Veterans Affairs Committee, told The Associated Press. In particular, auditors have pointed to the department's slow pace in improving access to medical care as well as a need for better implementation of a "Choice Program," authorized by Congress in 2015 to make it easier for veterans to get private care.

Government auditors also have cited continuing budget risks due to rising demand for veterans health care as a result of the Iraq and Afghanistan wars. The GAO, which previously found that schedulers were still manipulating wait times, notes in its upcoming report persistent problems with ambiguous VA policies and inadequate oversight.

Responding, the VA insisted that it had made steady progress and noted that it is difficult for most agencies to shed the GAO's "high-risk" rating in fewer than four years. Its health system is responsible for 9 million military veterans and includes more than 1,700 medical facilities.

"We are meeting regularly with the GAO and are making significant and irrefutable progress," the VA said. "We must stay focused and build on that progress in order to continue to provide veterans the high quality care and services they deserve."

The findings highlight the challenges awaiting President-elect Donald Trump, who has pledged an overhaul of VA but hasn't chosen anyone to run the government's second-largest agency. Veterans groups have urged him to move quickly to install a leader who can continue reforms put in place under current VA Secretary Bob McDonald. While problems persist, major veterans organizations have praised McDonald's willingness to work closely with them and believe improvements are generally on the right track.

The veterans groups also worry that other possible Trump picks could push for greater privatization of the VA, which they believe would siphon funds from VA medical centers as more services are outsourced to the private sector. They say VA centers are best equipped to handle unique battlefield injuries such as post-traumatic stress disorder.

Tester, the Montana senator, also expressed concern. Out of Trump's Cabinet-level positions, only the VA and Agriculture remain unfilled.

"Every day he continues to delay his decision, he jeopardizes the seamless transition that is needed to ensure this nation fulfills its commitment to the brave men and women who served," Tester said.

Trump met privately Monday with the VA's current undersecretary for health, David Shulkin. Joe Chenelly, national executive director of AMVETS, said his group was advised by a senior transition team adviser that Trump was "favorably inclined" to retain Shulkin, but no decision has been announced.

The GAO first listed VA health care as "high risk" in 2015, following the scandal in which as many as 40 veterans died. McDonald, who took the helm in 2014, highlights improvements including the hiring of additional doctors and staff and a new record for completed medical appointments at 5.3 million.

The restructuring, nicknamed "MyVA," is designed to provide veterans with a positive customer service experience, regardless of whether they use the department's website, call their local VA office or walk into a clinic.

In independent analyses in 2015 and 2016, the AP and GAO separately found little VA progress in reducing waits, with available VA data often misleading.

McDonald has acknowledged a slow pace in improving wait times, drawing criticism last year after suggesting that wait times shouldn't really matter in judging VA performance.

The department has an annual budget of nearly $167 billon, amid rising costs that have roughly tripled since 2002.

Some veterans groups have expressed support for keeping McDonald as secretary, but that would be a shift for Trump, who has blasted the VA as "the most corrupt agency" and "probably the most incompetently run agency."

During the campaign, Trump repeatedly pledged to fix the department's woes and said he would "take care of great veterans." His transition team last month signaled that Trump was weighing a "public-private option" in which veterans could get all their medical care in the private sector, with the government paying the bill, a stance that McDonald says should be treated with caution.

Amid stiff opposition from veterans groups and Democrats who oppose greater privatization, Trump's selection of a VA secretary has slowed.

Among the candidates Trump has considered are Leo Mackay, a Lockheed Martin executive; Pete Hegseth, former head of the conservative Concerned Veterans for America; former Massachusetts Sen. Scott Brown and former Florida Rep. Jeff Miller. Trump was earlier said to favor Cleveland Clinic CEO Toby Cosgrove, who favored greater privatization at the VA, but Cosgrove withdrew his name last month.

The Associated Press is an American multinational nonprofit news agency headquartered in New York City. The AP is owned by its contributing newspapers, radio, and television stations in the United States, all of which contribute stories to the AP and use material written by its staff journalists.

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